Garavello Alberto, Fransvea Pietro, Rossi Stefano, Giacovazzo Francesco, Marino Vincenza
Emergency Surgery and Trauma Care Unit, St. Filippo Neri's Hospital, Rome, Italy.
Faculty of Medicine and Psychology, "Sapienza" University of Rome, St. Andrea's Hospital, Italy.
Int J Surg Case Rep. 2018;51:331-334. doi: 10.1016/j.ijscr.2018.07.039. Epub 2018 Aug 9.
Gastrointestinal metastases from pulmonary neoplasm represent a rare but potentially fatal pathology that can complicate the disease in most advanced stages; this is a rare but well-known phenomenon in Literature and small intestine is the most common metastatic site. Generally these are patients with a known or surgically treated pulmonary neoplasm; the onset of pulmonary neoplastic disease with a symptomatic intestinal metastasis is to be considered extremely rare.
We report two cases of small intestine perforation from pulmonary metastasis; diagnosis was made at the time of exploratory laparotomy and the operation was in one patient the resection of the perforated bowel and in the second a resection and an intestinal bypass to overcome the stenosis caused by the metastatic masses. In the postoperative period, a patient died of pulmonary complications, the second was dismissed, but survival was only three months.
Intestinal metastasis of a pulmonary tumor is a rare occurrence but must be suspected in acute abdominal syndrome in a patient with a diagnosed pulmonary neoplasia.
Emergency surgical treatment of abdominal metastases of a lung cancer is mandatory but prognosis is extremely unfavorable.
肺肿瘤的胃肠道转移是一种罕见但可能致命的病理情况，在大多数晚期疾病中会使病情复杂化；这在文献中是一种罕见但广为人知的现象，小肠是最常见的转移部位。一般来说，这些患者患有已知的或接受过手术治疗的肺肿瘤；以有症状的肠道转移为表现的肺肿瘤疾病的发病极为罕见。
我们报告两例因肺转移导致小肠穿孔的病例；诊断是在剖腹探查时做出的，一例患者进行了穿孔肠段切除术，另一例进行了切除及肠旁路手术以克服转移瘤块导致的狭窄。术后，一名患者死于肺部并发症，另一名患者出院，但仅存活了三个月。
肺肿瘤的肠道转移很少见，但在已诊断肺肿瘤的患者出现急性腹部综合征时必须怀疑。
肺癌腹部转移的急诊手术治疗是必要的，但预后极差。
